MRT der Prostata: Empfehlungen zur Vorbereitung und Durchführung

Franiel, Tobias; Quentin, Michael; Mueller‐Lisse, Ullrich G.; Schimmoeller, Lars; Asbach, Patrick; Rödel, Stefan; Willinek, Winfried A.; Hueper, Katja; Beyersdorff, Dirk; Röthke, Matthias

doi:10.1055/s-0042-119451

Cited by 16 publications

(4 citation statements)

References 47 publications

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“…The joint recommendations of the American College of Radiology (ACR), the European Society of Urogenital Radiology (ESUR) and the AdmeTech Foundation regarding performance of MP-MRI of the prostate as well as standardized findings (PI-RADS v2) are an important step towards an international standard which can strengthen the trust of the referring physicians in the method [12]. In the German-speaking realm, one step in this direction includes, among other things, current standardized implementation and protocol recommendations for prostate MRI [25]. Individual studies which continue to promote the use of their own Likert scales suggest that uniform, standardized diagnosis must be further developed [26].…”

Section: Discussionmentioning

confidence: 99%

Current Utilization and Acceptance of Multiparametric MRI in the Diagnosis of Prostate Cancer. A Regional Survey

Ullrich

Schimmöller

Oymanns

et al. 2017

Fortschr Röntgenstr

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/2 11/8 11 77 54 Fax: ++ 49/2 11/8 11 61 45 lars.schimmoeller@med.uni-duesseldorf.de ABSTR AC TPurpose To assess the current regional acceptance, valuation, and clinical role of multiparametric MRI (mp-MRI) in prostate cancer diagnostics by patients and physicians. Materials and MethodsOf 482 distributed standardized questionnaires, 328 patient and 31 physician questionnaires (urological and general practitioners in and around Düssel-dorf) were analyzed over a period of 11 months. Questions were asked concerning general knowledge about prostate cancer, current diagnostic procedures, and knowledge about mp-MRI and MRI-guided biopsy.Results 70 % of the patients regarded accurate and exact diagnostics of prostate carcinomas as very important and 68 % considered MP-MRI a useful technique. 28 % of the patients with elevated PSA levels and negative transrectal ultrasound-guided biopsy (TRUS-GB) received MP-MRI as a secondary diagnostic. More than half of the patients estimated their overall knowledge about prostate cancer mediocre or worse and wished for more information about MR diagnostics. The majority of physicians (55 %) ordered MP-MRI studies of the prostate and 68 % saw their basic role in secondary diagnostics.Conclusion In this regional assessment mp-MRI of the prostate was considered useful by patients and practitioners. Currently, there still is a considerable discrepancy between recommended and the actual number of conducted MP-MRI studies, particularly in patients after previous negative TRUS-GB, although practitioners already see the benefit in this patient collective. Even though the use of prostate MRI is frequently more established than suggested in the current German S3-guideline, its full potential has not yet been exploited. More comprehensive information about the applications and diagnostic benefits of prostate MRI is needed and desired among patients and physicians.

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Section: Discussionmentioning

confidence: 99%

Current Utilization and Acceptance of Multiparametric MRI in the Diagnosis of Prostate Cancer. A Regional Survey

Ullrich

Schimmöller

Oymanns

et al. 2017

Fortschr Röntgenstr

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“…Additionally, systematic biopsy alone fails to detect up to 20 % of significant carcinomas [7]. Today, mpMRI, consisting of T2w, DW, and dynamic contrast-enhanced (DCE) imaging, has shown substantial value in the staging, detection, localization, characterization, risk stratification, surveillance, and assessment of suspected recurrence of PCa [6]. Data from systematic reviews and diagnostic studies indicate that a combination of MRI-assisted, targeted plus systematic biopsy achieves much better detection rates than the respective methods alone [2,8].…”

Section: Diagnostics and The Importance Of Mpmrimentioning

confidence: 99%

“…This demographic development must be taken into account in the diagnosis, treatment, and follow-up care of PCa. Conventional diffusion-weighted imaging (DWI) was shown to add incremental value to T2-weighted (T2w) magnetic resonance imaging (MRI) in the detection and localization of PCa, making it a key component of the prostate multiparametric MRI (mpMRI) exam [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Multiparametric MRI in the Diagnosis of Prostate Cancer: Physical Foundations, Limitations, and Prospective Advances of Diffusion-Weighted MRI

Wichtmann

Zöllner

Attenberger

et al. 2020

Rofo

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Background Diffusion-weighted imaging (DWI) is an essential component of the multiparametric MRI exam for the diagnosis and assessment of prostate cancer (PCa). Over the last two decades, various models have been developed to quantitatively correlate the DWI signal with microstructural characteristics of prostate tissue. The simplest approach (ADC: apparent diffusion coefficient) – currently established as the clinical standard – describes monoexponential decay of the DWI signal. While numerous studies have shown an inverse correlation of ADC values with the Gleason score, the ADC model lacks specificity and is based on water diffusion dynamics that are not true in human tissue. This article aims to explain the biophysical limitations of the standard DWI model and to discuss the potential of more complex, advanced DWI models. Methods This article is a review based on a selective literature review. Results Four phenomenological DWI models are introduced: diffusion tensor imaging, intravoxel incoherent motion, biexponential model, and diffusion kurtosis imaging. Their parameters may potentially improve PCa diagnostics but show varying degrees of statistical significance with respect to the detection and characterization of PCa in current studies. Phenomenological model parameters lack specificity, which has motivated the development of more descriptive tissue models that directly relate microstructural features to the DWI signal. Finally, we present two of such structural models, i. e. the VERDICT (Vascular, Extracellular, and Restricted Diffusion for Cytometry in Tumors) and RSI (Restriction Spectrum Imaging) model. Both have shown promising results in initial studies regarding the characterization and prognosis of PCa. Conclusion Recent developments in DWI techniques promise increasing accuracy and more specific statements about microstructural changes of PCa. However, further studies are necessary to establish a standardized DWI protocol for the diagnosis of PCa. Key Points: Citation Format

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“…Axiale a und koronale b T2-gewichtete Bilder: signalgemindertes Prostatakarzinomsuspektes Areal links in der Transitionszone mediobasal (Pfeile). Fokal abgesenkter scheinbarer Diffusionskoeffizient (ADC) c. Korrespondierende Signalanhebung im DWI-Bild mit hohem b-Wert (b = 1400 s/mm²) d. Dynamische kontrastmittelunterstützte Bilder (DCE) und berechnete Farbkarte e, f. PI-RADS-Gesamtscore 5.Diagnostische und Interventionelle Radiologie angeforderte multiparametrische MRT wurde routinemäßig unter Beachtung der internationalen und deutschen Empfehlungen durchgeführt[6,7]. Es zeigte sich ein auffälliges anterolaterales Areal mit einer Läsionsgröße von > 1,5 cm.…”

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MRT-(inbore)-Biopsie zur sicheren Detektion kleiner oder ungünstig gelegener Prostatakarzinome bei negativer MRT/Ultraschall-Fusionsbiopsie

Klingebiel¹,

Ullrich²,

Robert

et al. 2020

TumorDiagnostik & Therapie

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ZusammenfassungDie multiparametrische MRT der Prostata und MR-gezielte Biopsieverfahren werden zunehmend durchgeführt und durch aktuelle Leitlinien empfohlen. Ein diagnostisches Problem stellen Diskrepanzen wie ein auffälliger MRT-Befund mit jedoch anschließend negativer gezielter Biopsie dar. Neben der MRT-Qualität und MRT-Befundung ist auch die MR-gezielte Biopsie eine potentielle Fehlerquelle der Diagnostikkette. Die MRT-(in-bore)-Biopsie kann als genaustes gezieltes Prostatabiopsieverfahren eine fehlerhafte oder verzögerte Therapie bei Patienten mit initial negativem oder nicht zum MRT-Befund passendem Ergebnis der gezielten Ultraschall-gesteuerten Biopsie vermeiden. Im Folgenden werden zwei Fälle aus der klinischen Routine beschrieben in denen die MRT-(in-bore)-Biopsie als „Back-up“-Verfahren genutzt wurde.

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MRT der Prostata: Empfehlungen zur Vorbereitung und Durchführung

Cited by 16 publications

References 47 publications

Current Utilization and Acceptance of Multiparametric MRI in the Diagnosis of Prostate Cancer. A Regional Survey

Current Utilization and Acceptance of Multiparametric MRI in the Diagnosis of Prostate Cancer. A Regional Survey

Multiparametric MRI in the Diagnosis of Prostate Cancer: Physical Foundations, Limitations, and Prospective Advances of Diffusion-Weighted MRI

MRT-(inbore)-Biopsie zur sicheren Detektion kleiner oder ungünstig gelegener Prostatakarzinome bei negativer MRT/Ultraschall-Fusionsbiopsie

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